Growing Older, Staying Strong

Oct. 15, 2001 -- Yetta H. Appel, DSW, has been through treatment for colon cancer, a broken leg, and cataract surgery. She nursed her husband, Hy, through Parkinson's disease until his death. None of these recent events kept her from celebrating her 78th birthday in Lithuania, during a trip to honor people who'd aided Jews during the Holocaust.

"Because I was a social worker for many years, I've developed a knack for relating to people," she says. "I try to reach out to people on my block. I recognize what's meaningful to them; I remember their birthdays. In response, they include me in their lives. As we age, it's important to stay interested in others."

Until reaching mandatory retirement at age 70, Appel was a professor of social work at Rutgers University in New Brunswick, N.J.

All of us grow older every day. But people like Appel seem to have a knack for graceful aging. What is their secret?

Maintain Social Connections

It's important to stay engaged with others, says Jessie C. Gruman, PhD, executive director of the Center for the Advancement of Health in Washington, D.C.

"When someone retires from the workforce, and their children move away, they may not have the social stimulation that comes routinely with employment and an active family life," Gruman tells WebMD. "It's important to recognize this potential problem and to take steps to stay socially and mentally engaged. Read the newspaper. Read books. Put yourself in a position where you're continually challenged."

Maintaining social connections has an important effect on quality of life, agrees Laura Mosqueda, MD, director of geriatrics and associate professor of family medicine at the University of California in Irvine. "People can reach out to form new relationships by volunteering, or pursuing special interests and hobbies, or exploring activities at local senior centers," she tells WebMD.

It's important to recognize that depression is not a normal part of aging. "It's normal to grieve after a loss, but it's not normal to feel sad all the time," Mosqueda says. "In older adults depression may manifest as irritability, memory loss, or social withdrawal. Clinical depression is an illness that can and should be treated."

Gruman predicts that we're on the cusp of a dramatic change in our expectations about the aging process. "The baby boomers have no intention of going gentle into that good night. They expect and hope to stay extremely active until one day they wake up dead," she says. In the past, a gradual decline in activity was the "culturally accepted norm," Gruman adds -- but the baby boomers aren't likely to accept this. She expects this computer-adapted generation to find new ways to overcome physical limitations and social isolation.

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Diet and Exercise Key

The two most important keys to successful aging are diet and exercise, says John Faulkner, PhD, senior researcher at the Muscle Mechanics Laboratory in the Institute of Gerontology and professor of physiology and biomedical engineering at the University of Michigan in Ann Arbor.

"The most critical thing as we age is maintaining the ability to move, and that means having a reasonable body weight," Faulkner says. "Your metabolism continues to slow down steadily every decade. We need less food today than we did 10 years ago."

In addition to eating a well-balanced diet, it's essential to continue to exercise throughout life. "Find something that appeals to you, because few people will continue to engage in exercise unless they enjoy it," Faulkner says. "It's critical to understand that you will lose muscle mass as you grow older. At age 80 people generally have about 50% to 60% of the muscle mass they had when they were 30. If you work out regularly with modest weights you can prevent some of that loss. Instead of losing 40% of your muscle mass, you might only lose 30%." Gruman adds that working out with small weights not only builds muscle mass but also helps fight osteoporosis and strengthens muscles that preserve balance.

Mosqueda, too, emphasizes the importance of continuing exercise.

"Regular exercise maintains flexibility and functioning, and helps prevent falls," she says. "It doesn't matter what age you are. At any age you can exercise and increase your physical and social well-being." She recommends a program that includes both aerobic exercise to increase blood flow and a gentler exercise like tai chi to increase flexibility and balance.

Adapt Gracefully to Change

"We find that people who age successfully and have a good quality of life adapt well to changes," Mosqueda says. "If they can't square dance any more, they try ballroom dancing. If they can't run marathons, they shift to shorter runs. Instead of feeling 'there's nothing else I can do,' they look for solutions."

When Appel traveled to Eastern Europe, she couldn't always keep up with her group. "Just be sure to keep me in sight, and I'll arrive a few minutes after you," she told them. When she came to a staircase with no handrails and needed help, she asked for it. "It's important not to feel that 'this is only happening to me,'" she says. "Keep in mind that people of all ages have to deal with changes in their abilities. Find a balance. Work to improve what you can do, and at the same time acknowledge your limits."

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Shifting Sense of What Matters

As we age, our sense of what's important changes. "Because people aren't so tied down to the demands of daily living, they may have more time to develop a rich spiritual life," says Gruman. "They may become more deeply involved in their own religion or explore new spiritual directions."

Appel says she believes this is related to shifting perceptions of time. "As you reach your 70s and 80s you no longer sense time stretching out in front of you indefinitely," she says. "For successful aging, we need to let go of self-focused concerns from our younger years. Recently, as I realize more deeply that time is short, I find I want to be as open and forgiving as I possibly can be."